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High levels of bad cholesterol in early middle age are linked to CVD risk decades later, study finds

BMJ 2019; 367 doi: (Published 04 December 2019) Cite this as: BMJ 2019;367:l6814
  1. Nigel Hawkes
  1. London

Taking action to reduce “bad” cholesterol much earlier in life could prevent many cardiovascular events, a long term study has suggested.

Few people under 45 know their cholesterol levels, but the study shows that having high levels of non-HDL (non-high density lipoprotein) cholesterol at that age is associated with an increased risk of cardiovascular disease decades later.

The implication is that lowering these levels earlier—by diet, exercise, or drugs—could have huge benefits, said the authors of the study, who used data collected by the Multinational Cardiovascular Risk Consortium from more than 500 000 people in Europe, Australia, and North America.

Long term follow-up of these people showed that, the higher the levels of non-HDL cholesterol at the start of the study, the greater the risk of cardiovascular events. This in itself is no surprise, since the link between the bad forms of cholesterol (traditionally labelled LDL cholesterol) and heart disease risk is well established. But the trials that established the link were all short term, …

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